STATE OF INDIANA )
)SS:
COUNTY OF WELLS )
IN THE WELLS
SUPERIOR COURT
CAUSE NO.
90D01-2401-MI-000006
IN RE THE NAME CHANGE OF: )
MADELINE GRACE QUEENER )
Petitioner )
VERIFIED PETITION TO CHANGE NAME
Petitioner, by counsel, submits this petition in order to change their name. In support of this motion, Petitioner states:
1. My current name is Madeline Grace Queener
2. My date of birth is March 3, 1999.
3. My Indiana Driver’s License number is ****-**-****
4. I am a student at Arizona State University and reside at 420 E. Garfield St., Tempe, AZ 85228 during the school year.
5. My permanent address and mailing address is 417 Ridge Court, Ossian, IN 46777.
6. I have no previous names.
7. I am a United States citizen as evidenced by my Consular Report of Birth Abroad, attached as Exhibit A.
8. I do not have any felony convictions.
9. I am not seeking to defraud creditors by changing the name on my birth certificate.
10. I have a current, valid passport.
11. I am not a sex or violent offender who is required to register under I.C. 11-8-8.
12. I will publish notice of my request for a name change in a local publication as required by law and will bring proof of publication to the hearing.
13. Pursuant to I.C. 34-28-2-1, and Indiana Common Law, I wish to change my name to Maxwell Gregor Queener.
14. The United States State Department will amend my Consular Report of Birth Abroad to reflect my new name upon receipt of this Court’s order changing my name.
WHEREFORE, I respectfully request that this Court grant my Petition to Change Name and all other just and proper relief.
I affirm under the penalties of perjury that the foregoing is true and accurate.
/s/Madeline Grace Queener
Madeline Grace Queener
Respectfully Submitted,
/s/David G. Crell
David G. Crell (28512-02)
Andrews & Crell, P.C.
116 S. Main St.
Bluffton, Indiana 46714
(260) 824-4049
Attorney for Petitioner
STATE OF INDIANA )
)SS:
COUNTY OF WELLS )
IN THE WELLS
SUPERIOR COURT
CAUSE NO.
90D01-2401-MI-000006
IN RE THE NAME CHANGE OF: )
MADELINE GRACE QUEENER )
Petitioner )
NOTICE BY PUBLICATION
To: Any person who may be interested in the cause of action filed herein
You are hereby notified that Madeline Grace Queener has filed a petition to change the name on her birth certificate from Madeline Grace Queener to Maxwell Gregor Queener. Her current legal name will remain unchanged.
A written answer or response to this Petition must be made in writing by you or your attorney on or before thirty (30) days after the date of the final publication of this Notice. If you fail to do so, a judgment may be entered for the relief demanded by the Petitioner in the Petition.
Respectfully submitted,
/s/David G. Crell
David G. Crell, #28512-02
Andrews & Crell, PC
116 S. Main St.
Bluffton, Indiana 46714
(260) 824-4049
Attorney for Petitioner
STATE OF INDIANA )
)SS:
COUNTY OF WELLS )
IN THE WELLS
SUPERIOR COURT
CAUSE NO.
90D01-2401-MI-000006
IN RE THE NAME CHANGE OF: )
MADELINE GRACE QUEENER )
Petitioner )
NOTICE OF HEARING/
ORDER TO APPEAR
Comes now the Petitioner, by counsel, David G. Crell, and having filed a Verified Petition to Change Name, and the Court being duly advised in the premises now sets the same for hearing on March 27, 2024, at 8:30 a.m. in the Wells Superior Court, Courthouse, Bluffton, Indiana.
Dated this January 29, 2024.
Judge, Wells Superior Court
Distribution:
All Parties
nb 1/31, 2/7, 2/14
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